Pilot program offers one-on-one consultations

Program to improve care and save money

By calling an 800 number and paying a $5 fee, residents in four Wyoming cities can have face-to-face consultations with clinical pharmacists, who not only review the residents’ health and medication history but make cost-saving suggestions as well.

"With the rising cost of medications and with so many people — especially seniors — having to pay for them on their own, it is a real benefit to have a pharmacist consultation that takes a professional look at their medications and sees if there are perhaps some alternative choices," says Aimee Lewis, PharmD, pharmacist consultant with the Wyoming Department of Health.

To become part of the program, residents in Casper, Cheyenne, Laramie, and Torrington first call the Wyoming Pharmacist 800 number. The number is being marketed through flyers and some newspaper ads sponsored by AARP Wyoming. The Department of Health has emphasized that this is not an information hotline. "A pharmacist does not answer the phone," she says. "Instead, the 800 number focuses on getting residents one-on-one consultations in their area."

The Department of Health has contracted with the University of Wyoming School of Pharmacy in Laramie to man the call center and provide consulting services. When a resident calls the number, a receptionist takes basic information and sends the resident a form packet. The resident fills out the form and sends it to the Department of Health.

The form asks for demographic information to help with statistical tracking of the program, Lewis notes. The resident also is asked to list every medication he or she is taking, including over-the-counter and herbal medications. In addition, the resident is asked to list physician and insurance information. "We might be able to look at their [health plan] formularies and make appropriate changes for the residents," she adds.

Once the Department of Health receives the form and the resident’s $5 consultation fee, the resident is assigned a clinical faculty member from the school of pharmacy who is under contract with the program. "Once the consultant pharmacist gets the information, we ask that he or she contacts the person within two weeks to set up a time to meet," Lewis says.

At this point the Department of Health does not use specific guidelines as to how the pharmacists conduct the consultation. "These pharmacists generally work in hospitals or family practice-type settings so [this kind of consultation] is something they generally do on a daily basis," she says. The pharmacists receive $70 for each consultation.

If the program expands or goes statewide, however, the department may offer a continuing education (CE) or some other training program for pharmacists who are interested. The pharmacists would contract with the program directly through the department. The CE or training program probably would provide a format for the consultation to make it more systematic, Lewis reports.

The process for the pilot program began when Ralph Bartholomew, RPh, spoke to the Wyoming legislature about a similar project he had set up at a company in Worland, WY. "He spoke about how he was saving his clients some money on their prescription drug bills," Lewis recalls. Bartholomew’s successful lobbying helped get the legislation passed last session, and partial funding became available July 1, 2003. The Department of Health immediately began working on setting up the pilot program, which was implemented Dec. 4.

As of Jan. 2 — the first month of operation — the hotline has received 80 calls, which have resulted in 97 packets of information being mailed, she reports. About 50 forms have been returned and sent out for consultations.

The pilot program offers a great service to the residents of the four cities, according to Lewis. Residents may have multiple prescribers who may or may not be aware of all the drugs the residents are taking.

The pharmacists can look at the residents’ overall drug regimen to make sure none of the drugs have adverse effects or negatively react with each other. The pharmacists also can make suggestions about alternative medications that may save the residents money.

For example, if they take prescription Prilosec and they can take the over-the-counter version instead, it could save them from $40 to $60 a month depending on the strength and how much they are taking, Lewis says.

After the consultation, the pharmacists make recommendations that are sent to the residents as well as to their prescribers, who should approve any changes to the residents’ medications. "I think the consultations will not only save money but will result in better care for the patient," she says.